We were scheduled to do the longest zip line in Asia and go white water rafting. On the first day, we started with the zip line. It was a rather long trip on bumpy roads after an hour and a half of air travel. I knew that I was afraid of heights but it didn’t really bother me, at least initially, that we were doing the zip line. As we approached the park, my heart started pounding slowly though it still didn’t bother me that much. When we reached the park, I noticed that I could already feel my heart beating stronger and I was already starting to feel queasy. I wanted to tell my friends to go ahead but at the back of my mind, I knew that it was something that I had to do. My palpitations got stronger and stronger as we approached the platform where the zip line starts. My friends were cracking jokes as we were travelling towards the platform but I could only half-heartedly laugh at them as my mind was so consumed with all my fearful thoughts.

The initial ritual was the strapping of the vest and a short climb towards the platform. When I stepped on the platform, my heart started pounding madly and I really felt so scared that I wanted to cry. I was standing in a place where just one step forward is victory and one step backward is sheer cowardice. I wanted to beg off and go back but I knew in my mind that I will never be able to forgive myself if I didn’t do it. Not doing it was something that will bother me forever. I knew that I will nag myself of the fact that I was already there after the long journey then I chickened out. When my friend invited me to back out, I was quite ready to oblige. I was so torn…..then came our turn! My palpitations grew stronger and I could feel the gush of blood in my face as they were already strapping me to the line. It was a moment of intense fear ravaging through my entire being. It was a kind of fear that I have never experienced ever in my whole life. It paled in comparison to all the interviews and conferences in my entire medical life.

The initial moment of release from the platform was extremely terrifying. It was literally venturing into the unknown. I had no idea what will happen……all I knew was that I am very afraid, tense, anxious, palpitating, almost going insane. But after a few moments in mid air, the feeling started to shift to one of enjoyment, fun and rapture. At the end of the line, I felt so exhilarated with a sense of accomplishment. I did it!!! I did it!!!….and I never thought that it would be so much fun!!!! I wanted to do it again! Well done woohoo!!!

The following day, we went white water rafting. Again, I felt nervous and scared. They told us that our raft could capsize and we can all get thrown into the rushing waters. I knew how to swim but I’ve heard scary stories that made me more nervous. Despite my fears, I went ahead but I remember that the anticipation was almost unbearable. My mind was screaming…..”LET’S GET THIS OVER WITH!!!” But just like the day before with the zip line, it was so much fun that I’d do it over and over.

That vacation was not only fun but quite life-changing for me. The thoughts, fears, emotions and reactions I experienced prior to actually doing the tasks were a microcosm of what happens in our lives. We gravitate towards what is comfortable most of the time, fearing the unknown, staying where it is familiar, cooking up rationalizations of why we can’t or shouldn’t, making up all sorts of excuses. What I realized with that experience was that the FEAR was actually worse than the thing itself….that the battleground is not in reality but it is in the realm of our minds. Staying comfortable as what we always do can rob us of being fully alive. It depletes the soul of life, of passion, of joy, of exhilaration…..But venturing into the unknown, making the leap and taking the risk are what keep us fully alive and present in our lives. These are the things that give meaning to our lives but sadly, most of us linger on where it is safe until life gives us a jolt. Hopefully, the jolt is not too late that we can no longer make up for what has been lost.

By staying safe and comfortable, we lose the opportunity of finding out what could BE. By staying safe and comfortable, we get an absolute no for an answer to the questions in our lives. By staying safe, we miss out on the possibility of joy, happiness, a sense of accomplishment and experiencing what could be in our lives. And the sad part is that, for most of us, we quit without even having tried. But taking the risks can produce magic in our lives and open up possibilities that we never though could happen.

Whatever the thing is that we are putting off, by staying safe, we miss out on who and what we could be…..and most of all, we miss out on life.

The river span about half a mile wide bordered on one side by a mountain of boulders with a hole which served like an entrance to a cave. On the other side was lush greenery consisting of trees and grasses. Out of the clear sky, one will notice stretching across the width of the river, from the boulder on one side to a pole made of bamboo implanted on the other side of the river was a thick, sturdy rope. Hanging on the rope parked on one side is a wood frame that seemed like a chair made from scrap pieces of wood. Below this wooden frame is a makeshift raft made from pieces of bamboo pole tied together by ropes.

I asked Kumar, our amazing rafter, what those structures are for. He replied that they are used to transport kids to and from school. The children will step on the raft with water ankle deep and cross the river carrying their shoes and bags on their head. Upon reaching the boulder side of the river, they will go up a makeshift stair made from a single bamboo pole with pieces of wood attached to it in a manner that simulates a ladder. Before reaching the river crossing, the children will have to walk between 20-30 minutes on each side. This means that the children will spend around 1 hour going to school and another hour going back home all done on foot.

I’ve previously heard of stories of children having to walk for hours just to get to and from school but it has never affected me as much as when I actually saw and heard the story of the children and how they cross the river. After hearing this story, I couldn’t help but remember the times that I complained in traffic while riding in my airconditioned car with the music playing and talking to my friends on the cell phone. I couldn’t help but remember all those times that I waited impatiently albeit comfortably for my turn to pay the bills. I couldn’t help but remember all the times that I complained and whined and wished that my life would get better.

Life is awesome…Stop complaining! The glass is not half empty…..it’s half full.

So is bread really better than rice?………..

Bread and rice are both sources of carbohydrates. Once eaten and digested, they are both converted to sugar (or glucose) in the body. When eaten inappropriately, both of them can lead to weight gain and when eaten appropriately, either of them may result to weight loss.

Eating bread per se or simply switching from rice to bread will not cause anybody to lose weight. Weight loss will only result when the total number of calories consumed (regardless of the source of calories, whether carbohydrates, simple sugars, protein or fats) is less than the total amount of calories burned by the body.

If you were previously eating the following for dinner: one half cup of rice, 2 pcs of fried chicken and one half cup of vegetables, simply changing the rice to bread but maintaining the rest of the meal might not cause you to lose weight. However, if you stop eating the fried chicken as well and switch to bread and maintain the vegetables, there is a chance that you might lose weight (that is, if you don’t add to the total amount of snacking you do in-between meals). But if you switch to bread and felt that the bread needs butter and at the same time you don’t eliminate the fried chicken or reduce its quantity, then you are simply adding more calories to the rice by using butter. You are more likely to gain weight.

Another important thing to remember is quantity. One half cup of rice is approximately equivalent to 2 slices of the “tasty” bread. So if you switch from ½ cup rice to 4 pcs of bread (without butter, mayonnaise or jam), you are consuming more calories. It is also worth mentioning that in making bread, oil or shortening and sugar are added. The oil used may contain trans fats or saturated fats which are not heart friendly and the sugar added, if a lot is not good for diabetics.

Rosa is a mother whose young adult son is suffering from a terrible illness….and she has no money to support her son’s healthcare. Neither does he have health insurance. It’s a terrible situation to be in.  I feared for myself.

Even after she left, I couldn’t get her out of my mind.  Her image kept creeping back into my head.  I don’t want to suffer the same fate I said to myself.  A question then suddenly popped into my head “How can someone stay in the same job for more than 20 years that pays very little and has no health care benefits?”

At 43 years old, he was given 6 months to live.  He accepted his fate openly but he kept telling me to just relieve his pain because he has no money to support his treatment.  Eventually, he succumbed peacefully with no family of his own, very few loved ones and no properties of any sort to bequeath.

Lester grew up in a well-to-do family.  He was able to go to good schools through college and he lived a very comfortable life.  After graduation, he landed a job at a manufacturing company where he stayed up to the time of his illness.  Even while he was not earning a lot, he managed to live a comfortably because their family business somehow continued supporting him.  Unfortunately, the recent financial crisis really hit their business hard and it slowly declined until eventually, they had to close shop with some unpaid debts.  When he was diagnosed with illness, there was no more money left.  He has also consumed his health insurance but needed further treatment.

One of the benefits of being a doctor is getting to meet all sorts of people who have eye opening life stories.  My life has been led to a different path because of my insights from other people’s lives such as the people above.

Rosa and Lester are shining examples of those who have been lured into the comfort trap.

All of us tend to seek out the familiar, the known and the comfortable.  Most of us, given the choice, will opt for what is safe failing to take the risk even when we know that we are stuck and unable to move forward.  Being comfortable is a trap…..it nestles you in warmth, in the routine but it robs you of the fire in your soul.  It slowly and unbeknownst to you, eats you up until a big jolt hits you.  Hopefully that jolt is not yet too late.

As I write this article, one by one it dawned on me how profoundly the comfort trap has imprisoned me.  It occurred to me that all the excuses and rationalizations I’ve made are the ways that I keep myself snuggled in my comfort zone.  Are you also trapped?  I invite you to take a look too.

In my own quest for this fantasy, I’ve obliged to attend some business opportunity invitations. At all times, the room is packed with people from all walks of life. All in search of this holy grail.

During these meetings, the attendees are made to listen to live testimonials from people in the organization who have made it to the top. Almost uniformly, the speaker relates how he was once a lowly employee working from 8 to 5 often with unpaid overtime work, unable to spend time with his family, missing the childhood of his kids, having an unbalanced life and missing out on the juice of life due to work. This will be followed by being invited by a friend who asked him to “just listen” to the business opportunity meeting and the rest being history. He goes on to show his big house in an exclusive subdivision and another vacation house elsewhere, his flashy cars, the yearly international trips all paid for by the organization and most of all the free time that allows him to enjoy his life and be with his family. He goes on to say: “It’s so easy to achieve all these things. Just join us now and we’ll teach you how”. Wow!!! The talk is certainly mindblowing! Everyone in the room is salivating with envy. Then comes the how and slowly, one will feel the excitement slightly go down.

I don’t have anything against it. Of course they need to get the crowd all excited and pumped up, otherwise nobody will join them. And it’s true that the person who spoke really accomplished all of them. I also believe that if you stick it out with them and do your stuff, you may have a chance to be as good as their best performer.

However, don’t be fooled that it’s going to be easy. As is true in anything in life, nothing can be gained easily. To be good at something whether in school, career, business or our personal lives takes time, a lot of effort and sacrifices, persistence and some degree of failure. And so it is in these types of business. I don’t think the top performers in the organization were good at it right away and I don’t think this kind of business is applicable to just about anybody.

I do not mean to say that you should not get involved in this kind of business. Who knows, you might actually be good at it. However, you must realize that there is a learning curve in becoming good at the business and that you must definitely not leave your job way before you have a stable and reliable stream of money which is enough to support you and your family. In my analysis, you must have at least some of the following qualifications in order to be successful in this type of business.

1. You must have the willingness and humility to learn something which might be totally different from your professional background or what you are currently doing.
2. You should not have any qualms about selling because the initial stages of the business will definitely involve selling something.
3. You should be the type of person who likes being with people and can practically start a conversation instantly even with the strangers you fall in line with at the grocery store.
4. You should not be afraid of rejection because more people will reject you than be enticed in your business.
5. You should be willing to sacrifice your free time, at least initially, when you are doing this outside of your work hours because in order to make it big, you need to spend a lot of time generating contacts, calling them and meeting them in person.
6. You have to be consistent and persistent. You need to do the prescribed hours of calling, generating contacts and closing the sale before you achieve mastery.

So the next time you go to a business opportunity meeting, check yourself first in the mirror if you have what it takes.

This article appeared on the November 16, 2010 issue of the Business Mirror. http://www.businessmirror.com.ph/home/banking-a-finance/3738-the-lure-of-part-time-high-income-business

When I was a younger oncologist, I was very passionate about needing to tell everything about the condition to the patient and their relatives. I tell them that it is my job and responsibility to be straightforward and honest no matter how painful the truth is. I rationalized that the patient HAS to know in order that he may be prepared for the inevitable and be able to finish unfinished business. However, as I encounter more patients, I am noticing that there are some subsets of patients who are not quite ready to hear the bad news. There are patients who have left me because they were not ready to hear the truth no matter how compassionately it was delivered. They were just not yet ready for it.

Everyday I am faced with the dilemma to be straightforward and honest no matter what or should I play along and keep patients’ hope up. Perhaps one might say that it’s a simple question. The doctor must always keep the patient’s hope up. Not quite because there are implications of this action.

On one hand, there are patients who, when told of their prognosis, opt not to undergo active treatment. Even if I subscribe to the notion that it is the patient’s right to refuse treatment and this must be respected, there is always the voice that keeps on asking “What if?”. On the other hand, there are patients who would do anything and everything, even sell their last piece of property, for a slim chance of improvement. It’s like I’m always walking on a tightrope. I must carefully balance delivering the truth without shattering the patient’s hopes.

Which one would you prefer? Hope or Reality? I’d like to hear what you think.

Vomiting is an adverse effect of many chemotherapy drugs, but not all. It is very important to prevent chemotherapy-induced vomiting because it causes trauma to the patient physically and psychologically. If a patient vomits after the 1st chemotherapy, just the thought of going to the doctor can already trigger the response the next time around. It can then adversely affect patient’s compliance with treatment. Patients who experience vomiting may also feel averse to eating because of fear that this can trigger further vomiting. This can contribute to malnutrition which can further impair the patient’s already compromised immunity. Therefore, it is of utmost importance to prevent chemotherapy-associated vomiting.

Patients must be adequately covered with medicines to prevent vomiting and the drugs must be taken round-the-clock during the period when vomiting is expected (this period usually lasts for 3-5 days from the day the chemotherapy is given). It is always easier to prevent the condition than manage it when the patient is already vomiting. Uncontrolled vomiting may even lead to hospitalization due to inability to retain the oral medicines, dehydration and electrolyte imbalance.

Patients should discuss proper measures against vomiting with their physicians. They must be equipped with instructions regarding intake of additional medications and when to advise their physicians if the problem persists. Remember…….there is no reason to vomit.

Fruits are natural foods that our bodies need. They contain vitamins, minerals and phytonutrients that make our bodies function optimally and protect us from harm. However, consuming UNLIMITED QUANTITIES of whole fruits and fruit juices may not be good for some people such as those who have diabetes, a family history of diabetes or those who are already borderline diabetics because fruits contain a natural sugar called fructose which can send a patient’s blood sugar shooting up. This should not mean, though, that fruits are off-limits to these people but that they should be taken in appropriate quantities such as 1 small apple or orange or ½ ripe mango per serving.

Of more concern to me is when people mistake the intake of fruit juice concentrates (powdered concentrates such as those that can be bought from the grocery to be reconstituted) or the pre-packaged juices in plastic bottles or tetra bricks (even when they claim to have pulp bits)or juices that are labelled as “no sugar added” as healthier than softdrinks. Even though these fruit juices are fortified with Vitamins, they are not necessarily healthy because of their high sugar content. These juices are often prepared from synthetic ingredients to come up with products that look and taste like fruit juices. They can also contain between 5-10 teaspoons of sugar per 8 ounce serving which is equivalent to the amount of sugar in the same quantity of softdrinks. These are not allowable for patients with diabetes and certainly advisable to be avoided by borderline diabetics. Parents will be well-advised if they refrain from allowing their children to consume these types of drinks because they habituate the children’s taste buds to very sweet beverages. (I know of children and adults, too, who do not drink water at all because their tastes have been accustomed to sweetness and they have grown averse to the natural taste of water). Fruit juices and shakes served in restaurants also are sweetened with either sugar or syrup.

So, juices freshly prepared from the actual fruits are preferred than artificial fruit juices and in consumed only in small quantitites (less than 8 ounces). Adding sugar to fruit juices and shakes must be avoided or if necessary, 1-2 teaspoons only. Let us also learn to read labels and discern which products contain large quantities of added sugar.

A businessman in his late 60’s was diagnosed with advanced stage lung cancer. He was a very powerful man. Everybody obeyed his command. He had the ability to hire and fire at a moment’s notice. Even his family were afraid of him. He has been separated from his wife for 20 years and hasn’t spoken to her since the time of the separation.

When I informed him of his diagnosis, he was stoic. He shed no tears. He was quite accepting of his fate and was rather upbeat in the succeeding days. His children were quite surprised.

One day, while everybody was away, he picked up his phone and dialled a number. With his voice shaking, he asked “Is this Helen?”. The surprised voice on the other end of the line replied “Yes, who is this?”. “This is Eddie” said the man. “How are you doing? I called you to ask for forgiveness for all those years that I’ve been unkind to you”. The woman at the other end of the line started sobbing then said “The man I fell in love with has finally come back, Thank you my dear”.

Helen and Eddie are husband and wife who have lived separate lives for 2 decades. They’ve separated bitterly and lived as if the other was gone. It took a medical crisis to bring them back together.

In all the years that I’ve dealt with patients, I have come to realize that true healing doesn’t always lie in the healing of the physical body but in acceptance, in humility, in forgiveness and in letting go. The true miracle lies in the healing of our attitudes, of emotions, of the mind and of the spirit.

Keep on believing. Miracles still happen.

Christmas is just around the corner and what this means is that traffic in Metro Manila is going to get worse. People will be busy delivering gifts, OFWs are coming home to spend time with their families and there will be reunions and parties everywhere. Travel time on the streets of Metro Manila is sure is increase by at least 50%.

When I was in medical school, I used to record in a cassette tape (CD’s and ipods were not yet in fashion then) the lectures of my professors. I would listen to these tapes in my car while travelling to school from my house and back. That really helped a lot during exams and made productive use of travel time.

Fast forward to 2010 and the cassette tapes can only be found in museums. They have been replaced by CD’s and ipods with better sound quality. Nowadays, I no longer listen to cassette tapes in my car but listen instead to audiobooks. I purchase these audiobooks from www.audible.com because they have a vast collection of titles ranging from science to fiction to business and more. You simply purchase them online and can download them instantly. They are also cheaper than buying audiobooks in CD’s. By doing this, I am able to make use of precious time and learn while driving. Talk about multi-tasking. So Christmas traffic no longer worries me. I say,”Bring it on”.